Psychological Medicine

Review Article

Central coherence in eating disorders: a systematic review

C. Lopeza1 c1, K. Tchanturiaa1, D. Stahla2 and J. Treasurea3

a1 Division of Psychological Medicine, Eating Disorders Research Unit, Institute of Psychiatry, King's College London, London, UK

a2 Department of Biostatistics and Computing, Institute of Psychiatry, King's College London, London, UK

a3 Eating Disorders Research Unit, Department of Academic Psychiatry, King's College London, London, UK


Background This review systematically appraised the research evidence for local versus global information processing to test the hypothesis that people with eating disorders (ED) had weak central coherence.

Method Searches on Medline, EMBASE, PsycINFO and ISI Web of Science databases were conducted in November 2006 and subsequently updated in September 2007. Each search was conducted in two steps: (1) neuropsychological tasks measuring central coherence and (2) words related to cognitive functioning in eating disorders. Data were summarized in a meta-analysis if the number of studies for a given test was >5.

Results Data were extracted from 16 studies. Meta-analyses were conducted for four tasks obtaining moderate effect sizes. The majority of studies found global processing difficulties across the ED spectrum. The results are less clear regarding local processing.

Conclusions People with ED have difficulties in global processing. It is less certain as to whether they have superior local processing. Currently, there is insufficient evidence to refute the weak central coherence hypothesis.

(Received December 13 2007)

(Revised March 17 2008)

(Accepted March 31 2008)

(Online publication April 30 2008)


c1 Address for correspondence: C. Lopez, Eating Disorders Research Unit, 5th Floor, Academic Psychiatry Department, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK. (Email: